Form Rev 32 0051 - Temporary Registration Certificate
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1State of Washington
TEMPORARY REGISTRATION CERTIFICATE
Department of Revenue
NOT TRANSFERABLE
PO Box 34052
Seattle WA 98124-1052
Year
Opening Date
Closing Date
Period
Reg. No.__________________________________
Due Date__________________________________
Social Security No.___________________________________
Business Name_________________________________________________
Business Telephone_________________________________
Mailing Address________________________________________________
Name of Event______________________________________
City________________________________State______Zip_____________
Location of Activity__________________________________
Owner’s Name_________________________________________________
Type of Goods Sold/Service Provided__________________
PLEASE ANSWER THE FOLLOWING:
1)
Type of Business (Check one)
Sole Owner
Corporation
Independent Rep.
Association
Partnership
2)
Contact Person_________________________________________________________ Phone Number______________________________
3)
How many employees do you have working this activity in Washington State?_________________________
HAVING COMPLIED WITH REGISTRATION PROVISIONS OF RCW 82.12 OR 82.32, THE PERSON
NAMED HEREON IS AUTHORIZED TO ENGAGE IN BUSINESS IN THE STATE OF WASHINGTON
*****************************************************************************
COMBINED EXCISE TAX RETURN - SEE ATTACHED INSTRUCTIONS
STATE BUSINESS AND OCCUPATION TAX
Column 1
Columbn 2 *
Column 3
Col. 4
Column 5
Line
Tax Classification
Code
Gross Amount
Code
Deductions
Taxable Amount
Rate
Tax Due
No.
1
03
0399
.00506
2
58
5899
.02
3
04
0499
.01829
4
02
0299
.00471
*
TOTAL
DEDUCTIONS TAKEN BUT NOT EXPLAINED BELOW WILL BE DISALLOWED
See Small Business B&O
Tax Credit, Page 2
STATE SALES TAX AND USE TAX
5
Retail Sales Tax
01
0199
.065
Value of articles used by taxpayer as a consumer on which no
6
Use Tax
05
.065
Washington Sales Tax has been paid
*
_____________________________________________________________________________________
Explanation of Deduction
LOCAL CITY AND/OR COUNTY SALES AND USE TAX
(if more space is required, please attach the additional local tax information in the same format as below.)
LOCAL SALES TAX (Enter applicable rate of tax)
[45]
LOCAL USE TAX (Enter applicable rate of tax)
[46]
Line
Line
Taxable Amount
Rate
Tax Due City or Co.
Taxable Amount
Rate
Tax Due City or Co.
Location Code
Location Code
No.
No.
7
12
8
13
9
14
10
Totals
[11]
15
Totals
[16]
TAXABLE AMT MUST BE SAME AS LINE 4, COL 3
TOTAL LOCAL SALES TAX DUE
TAXABLE AMT MUST BE SAME AS LINE 6, COL 1
TOTAL USE TAX DUE
TRANSFER TO LINE 17 BELOW
TRANSFER TO LINE 17 BELOW
TO AVOID PENALTIES COMPLETE AND RETURN CERTIFICATE
*
BY DUE DATE INDICATED ABOVE.
TOTALS
Signature_______________________________________________
Line
No.
Item
Code
Amount
Phone____________________________Date__________________
17
Tax Due (add lines 1-16)
18
Small Business B&O Tax Credit (see page 2)
815 (
)
ADD PENALTY IF LATE
5% After Due Date
19
Total Tax Due (subtract line 18 form line 17)
10% 30 Days After Due Date
20
Penalty
20% 60 Days After Due Date
(Minimum $5.00)
21
Total Amount You Owe (add lines 19 and 20)
REV 32 0051 (4-01-96)
TAXPAYER - ORIGINAL + ONE COPY
COPY TO FIELD
ONE COPY TO OLYMPIA HEADQUARTERS
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